<div class="fsh-pop">
    <div id="add_form" class="layui-form">
    <input type="hidden" name="id" id="id" value="<%=id%>"/>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">昵称</label>
            <div class="layui-input-block">
                <input name="nickName" maxlength="20"  placeholder="请输入内容" class="layui-input" value="<%=nickName%>">
            </div>
        </div> 
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label"><i>*</i>省-市-区</label>
            <div class="layui-input-block">
                <input name="address" maxlength="20" lay-verify="required" placeholder="请输入内容" class="layui-input" value="<%=address%>">
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label"><i>*</i>生日日期</label>
            <div class="layui-input-block">
                <input name="birthday" maxlength="20" lay-verify="required" placeholder="请输入内容" class="layui-input" value="<%=birthday%>">
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">结婚日期</label>
            <div class="layui-input-block">
                <input name="marriedDate" maxlength="20"  placeholder="请输入内容" class="layui-input" value="<%=marriedDate%>">
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label"><i>*</i>恋爱日期</label>
            <div class="layui-input-block">
                <input name="loveDate" maxlength="20" lay-verify="required" placeholder="请输入内容" class="layui-input" value="<%=loveDate%>">
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">领证日期</label>
            <div class="layui-input-block">
                <input name="certificateDate" maxlength="20"  placeholder="请输入内容" class="layui-input" value="<%=certificateDate%>">
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label"><i>*</i>经期</label>
            <div class="layui-input-block">
                <input name="periodDate" maxlength="20" lay-verify="required" placeholder="请输入内容" class="layui-input" value="<%=periodDate%>">
            </div>
        </div>
    </div>
</div>